A validation of multiple malingering detection methods in a large clinical sample.

The purpose of this study is to further previous research that has shown that common neuropsychological tests can do "double duty" as test of motivation/malingering. Using a large clinical sample of 796 participants, it was found that the nine neuropsychological tests (when used together) were able to correctly identify litigant and nonlitigating groups. Failure on any two of the malingering tests suggested motivational/malingering issues. The groups consisted of mild, moderate, and severe traumatic brain-injured patients; chronic pain, depressed, community controls, and "malingering actors." Institutionalized and noninstitutionalized patient performance were also examined. This method showed 83% sensitivity and 100% specificity. A 0% false positive rate was found, suggesting good reliability especially in litigating settings. A group of patients for whom this method of motivational assessment might not be appropriate was also identified.